Pope Francis battled a hoarse voice and was bundled up in a thick coat as he presided over a Mass in St Peter’s Square before tens of thousands of faithful on Palm Sunday, a day after he left hospital following treatment for bronchitis.

The sun broke through the clouds during the Mass, one of the longest services on the church’s calendar, as Francis, red vestments placed over his coat, sat in a chair under a canopy erected in the square.

He took his place after standing and clutching a braided palm branch in a Pope mobile that drove at the tail end of a long, solemn procession of cardinals, other prelates and rank-and-file Catholics. Each participant carried palm fronds or olive tree branches.

Pope Francis
Francis on his Pope mobile in St Peter’s Square (Andrew Medichini/AP)

Francis, 86, received antibiotics administered intravenously during his three-day hospital stay. His last appearance in St Peter’s Square was for his regular Wednesday public audience before he was taken to Rome’s Gemelli Policlinic later that day after feeling ill.

His voice sounded strong as he opened the Mass, but later sounded strained. But despite that, Francis read a 15-minute speech, occasionally adding off-the-cuff remarks for emphasis or gesturing with a hand.

His homily focused on moments when people feel “extreme pain, love that fails, or is rejected or betrayed”.

He cited “children who are rejected or aborted”, as well as broken marriages, “forms of social exclusion, injustice and oppression, (and) the solitude of sickness”.

Pope Francis
Pope Francis sits on the Pope mobile on his way to the altar to celebrate Palm Sunday Mass (Andrew Medichini/AP)

Deviating from his prepared speech, Francis spoke about a homeless German man who died, “alone, abandoned”, under the colonnade circling St Peter’s Square, where homeless persons often sleep.

“I, too, need Jesus to caress me,” Francis said.

Palm Sunday marks Jesus’s entrance into Jerusalem in the time leading up to his crucifixion, which Christians observe on Good Friday.

Sunday’s Mass opened a heavy schedule of Holy Week appointments for the pontiff. The Vatican on Saturday said Francis would preside at the Holy Week ceremonies, which culminate with Easter Sunday Mass in the square on April 9.